Provider Demographics
NPI:1477870855
Name:BRESNAHAN, KAREN FAITH (PT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:FAITH
Last Name:BRESNAHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:BRESNAHAN
Other - Last Name:O'CONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:380 DIABLO RD STE 201
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-3410
Mailing Address - Country:US
Mailing Address - Phone:925-552-5787
Mailing Address - Fax:925-552-6173
Practice Address - Street 1:380 DIABLO RD STE 201
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3410
Practice Address - Country:US
Practice Address - Phone:925-552-5787
Practice Address - Fax:925-552-6173
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 14155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist